Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Jun 2015
ReviewIntimate partner violence: the role of nurses in protection of patients.
Intimate partner violence (IPV) is a worldwide epidemic that has been prevalent in society since biblical times. IPV affects women long after the abuse stops, with victims of IPV having generalized worsening of health, including depression and increased thoughts of suicide and suicide attempts. ⋯ Through regular screening and education clinicians can detect the violence before it is too late. Health care professionals have a unique opportunity to stop the cycle of abuse by intervening, promoting safety, and preventing the death of IPV victims.
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Crit Care Nurs Clin North Am · Jun 2015
ReviewAdvances in cerebral monitoring for the patient with traumatic brain injury.
A brief overview of the most common invasive and noninvasive monitoring tools collectively referred to using the term "multimodal monitoring" is provided. Caring for the critically ill patient with traumatic brain injury requires careful monitoring to prevent or reduce secondary brain injury. Concurrent to the growth of the subspecialty of neurocritical care, there has been a concerted effort to discover novel mechanisms to monitor the physiology of brain injury. The past 2 decades have witnessed an exponential growth in neurologic monitoring in terms of intracranial pressure, blood flow, metabolism, oxygenation, advanced neuroimaging, and electrophysiology.
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Injury in older adults is a looming public health crisis. This article provides a broad overview of geriatric trauma across the continuum of care. After a review of the epidemiology of geriatric trauma, optimal approaches to patient care are presented for triage and transport, trauma team activation and initial assessment, inpatient management, and injury prevention. Special emphasis is given to assessment of frailty, advanced care planning, and transitions of care.
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Airway management skills are critical to patient care in many settings. Patients with a difficult airway present unique challenges and considerations, and clinicians should assess for this condition by obtaining a thorough history and physical examination. Familiarity with difficult airway management guidelines, algorithms, tools, and techniques is essential to formulating a safe and effective plan for intubation as well as extubation. This article focuses on airway evaluation, identification, planning, extubation, and care of the patient with a difficult airway.
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Patients who require general anesthesia to undergo a surgical procedure often require mechanical ventilation during the perioperative period. Ventilators incorporated into modern anesthesia machines offer various options for patient management. The unique effects of general anesthesia and surgery on pulmonary physiology must be considered when selecting an individualized plan for mechanical ventilation during the perioperative period. In this article, the pulmonary effects of general anesthesia are reviewed and available options for mechanical ventilation of the anesthetized patient during the perioperative period are presented.